Characteristics of Breath Sounds
Characteristics of Breath Sounds
Characteristics of Breath Sounds
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Physical Findings in Selected Chest Disorders (cont’d)<br />
Condition<br />
Atelectasis<br />
(Lobar Obstruction)<br />
When a plug in a<br />
mainstem bronchus (as<br />
from mucus or a foreign<br />
object) obstructs air<br />
flow, affected lung<br />
tissue collapses into an<br />
airless state.<br />
Pleural Effusion<br />
Fluid accumulates in the<br />
pleural space, separates<br />
airfilled lung from the<br />
chest wall, blocking the<br />
transmission <strong>of</strong> sound.<br />
Pneumothorax<br />
When air leaks into the<br />
pleural space, usually<br />
unilaterally, the lung<br />
recoils from the chest<br />
wall. Pleural blocks<br />
transmission <strong>of</strong> sound.<br />
Percussion<br />
Note<br />
Dull over the<br />
airless area<br />
Dull to flat over<br />
the fluid<br />
Hyperresonanat<br />
Or tympanitic<br />
over the pleural<br />
air<br />
Trachea<br />
May be shifted<br />
toward<br />
involved side<br />
Shifted toward<br />
opposite side in<br />
a large effusion<br />
Shifted toward<br />
opposite side if<br />
much air<br />
<strong>Breath</strong> <strong>Sounds</strong><br />
Usually absent when<br />
bronchial plug persists.<br />
Exceptions include right<br />
upper lobe atelectasis,<br />
where adjacent tracheal<br />
sounds may be<br />
transmitted.<br />
Decreased to absent, but<br />
bronchial breath sounds<br />
may be heard near top <strong>of</strong><br />
large effusion<br />
Decreased to absent over<br />
the pleural air<br />
Adventitious<br />
<strong>Sounds</strong><br />
None<br />
None, except a<br />
possible pleural rub<br />
None, except a<br />
possible pleural rub<br />
Tactile Fremitus<br />
and Transmitted<br />
Voice <strong>Sounds</strong><br />
Usually absent<br />
when the bronchial<br />
plug persists. In<br />
exceptions, e.g.,<br />
right upper lobe<br />
atelectasis, may be<br />
increased<br />
Decreased to<br />
absent, but may be<br />
increased towards<br />
the top <strong>of</strong> a large<br />
effusion.<br />
Decreased to<br />
absent over the<br />
pleural air